The societal costs of femoral neck fracture patients treated with internal fixation

被引:66
作者
Zielinski, S. M. [1 ]
Bouwmans, C. A. M. [2 ]
Heetveld, M. J. [3 ]
Bhandari, M. [4 ]
Patka, P. [5 ]
Van Lieshout, E. M. M. [1 ]
机构
[1] Univ Med Ctr Rotterdam, Erasmus MC, Dept Surg Traumatol, NL-3000 CA Rotterdam, Netherlands
[2] Erasmus Univ, Inst Med Technol Assessment, NL-3000 DR Rotterdam, Netherlands
[3] Kennemer Gasthuis, Dept Surg, NL-2000 AK Haarlem, Netherlands
[4] McMaster Univ, Dept Clin Epidemiol & Biostat, Hamilton, ON L8N 3Z5, Canada
[5] Univ Med Ctr Rotterdam, Erasmus MC, Dept Emergency Med, NL-3000 CA Rotterdam, Netherlands
基金
美国国家卫生研究院; 加拿大健康研究院;
关键词
Costs; Femoral neck fracture; Healthcare consumption; Hip fracture; Internal fixation; DISPLACED FRACTURES; HEMIARTHROPLASTY; ARTHROPLASTY; CARE;
D O I
10.1007/s00198-013-2487-2
中图分类号
R5 [内科学];
学科分类号
100201 [内科学];
摘要
The study rationale was to provide a detailed overview of the costs for femoral neck fracture treatment with internal fixation in the Netherlands. Mean total costs per patient at 2-years follow-up were a,not sign19,425. Costs were higher for older, less healthy patients. Results are comparable to internationally published costs. The aim of this study was to provide a detailed overview of the cost and healthcare consumption of patients treated for a hip fracture with internal fixation. A secondary aim was to compare costs of patients who underwent a revision surgery with patients who did not. The study was performed alongside the Dutch sample of an international randomized controlled trial, concerning femoral neck fracture patients treated with internal fixation. Patient characteristics and healthcare consumption were collected. Total follow-up was 2 years. A societal perspective was adopted. Costs included hospital costs during primary stay and follow-up, and costs related to rehabilitation and changes in living situation. Costs were compared between non-revision surgery patients, implant removal patients, and revision arthroplasty patients. A total of 248 patients were included (mean age 71 years). Mean total costs per patient at 2-years follow-up were a,not sign19,425. In the non-revision surgery patients total costs were a,not sign17,405 (N = 137), in the implant removal patients a,not sign10,066 (N = 38), and in the revision arthroplasty patients a,not sign26,733 (N = 67). The main contributing costs were related to the primary surgery, admission days, physical therapy, and revision surgeries. The main determinant was the costs of admission to a rehabilitation center/nursing home. Costs were specifically high in elderly with comorbidity, who were less independent pre-fracture, and have a longer admission to the hospital and/or a nursing home. Costs were also higher in revision surgery patients. The 2-years follow-up costs in our study were comparable to published costs in other Western societies.
引用
收藏
页码:875 / 885
页数:11
相关论文
共 20 条
[1]
Treatment of Displaced Femoral Neck Fractures in the Elderly: A Cost-Benefit Analysis [J].
Alolabi, Bashar ;
Bajammal, Sohail ;
Shirali, Janhavi ;
Karanicolas, Paul J. ;
Gafni, Amiram ;
Bhandari, Mohit .
JOURNAL OF ORTHOPAEDIC TRAUMA, 2009, 23 (06) :442-446
[2]
[Anonymous], 2010, HANDLEIDING KOSTENON
[3]
[Anonymous], 2002, MANUAL TRIMBOS IMTA
[4]
Internal fixation compared with arthroplasty for displaced fractures of the femoral neck - A meta-analysis [J].
Bhandari, M ;
Devereaux, PJ ;
Swiontkowski, MF ;
Tornetta, P ;
Obremskey, W ;
Koval, KJ ;
Nork, S ;
Sprague, S ;
Schemitsch, EH ;
Guyatt, GH .
JOURNAL OF BONE AND JOINT SURGERY-AMERICAN VOLUME, 2003, 85A (09) :1673-1681
[5]
Effects of extended outpatient rehabilitation after hip fracture - A randomized controlled trial [J].
Binder, EF ;
Brown, M ;
Sinacore, DR ;
Steger-May, K ;
Yarasheski, KE ;
Schechtman, KB .
JAMA-JOURNAL OF THE AMERICAN MEDICAL ASSOCIATION, 2004, 292 (07) :837-846
[6]
Hemiarthroplasty compared to internal fixation with percutaneous cannulated screws as treatment of displaced femoral neck fractures in the elderly: cost-utility analysis performed alongside a randomized, controlled trial [J].
Bjornelv, G. M. Waaler ;
Frihagen, F. ;
Madsen, J. E. ;
Nordsletten, L. ;
Aas, E. .
OSTEOPOROSIS INTERNATIONAL, 2012, 23 (06) :1711-1719
[7]
Blomfeldt R, 2005, J BONE JOINT SURG BR, V87B, P523, DOI 10.1302/0301-620X.87B4
[8]
Feasibility, reliability and validity of a questionnaire on healthcare consumption and productivity loss in patients with a psychiatric disorder (TiC-P) [J].
Bouwmans, Clazien ;
Jong, Kim De ;
Timman, Reinier ;
Zijlstra-Vlasveld, Moniek ;
Van der Feltz-Cornelis, Christina ;
Tan, Siok Swan ;
Hakkaart-van Roijen, Leona .
BMC HEALTH SERVICES RESEARCH, 2013, 13
[9]
The cost of hemiarthroplasty compared to that of internal fixation for femoral neck fractures 2-year results involving 222 patients based on a randomized controlled trial [J].
Frihagen, Frede ;
Waaler, Gudrun M. ;
Madsen, Jan Erik ;
Nordsletten, Lars ;
Aspaas, Silje ;
Aas, Eline .
ACTA ORTHOPAEDICA, 2010, 81 (04) :446-452
[10]
World-wide projections for hip fracture [J].
Gullberg, B ;
Johnell, O ;
Kanis, JA .
OSTEOPOROSIS INTERNATIONAL, 1997, 7 (05) :407-413